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Anatomy > Secondary pelvis and perineum > Flashcards

Secondary pelvis and perineum Flashcards

1
Q

What forms the pelvis?

A

hip bones, sacrum, coccyx

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2
Q

What are the pelvis functions?

A

transfers weight of the upper body to the lower body, withstands compression, houses and protects pelvic viscera

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3
Q

What is the pelvic brim?

A

Divides true and false pelvis (false - bigger circle) (true - smaller inlet)

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4
Q

What’s the difference between true and false pelvis?

A

false “greater” – loops of the ileum, sigmoid colon
true “lesser” – urinary bladder and reproductive organs

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5
Q

What are the hip bones?

A

ilium, ischium, pubis

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6
Q

What is the obturator foramen?

A

between ischium-pubis

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7
Q

What is the acetabulum?

A

where the femur head rests

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8
Q

What does the lumbar vertebrae do?

A

1) formation of posterior wall
2) allows flexion and extension
3) curvature or lordosis
4) site of fracture

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9
Q

What are the four joints of the pelvis?

A

1) sacrococcygeal
2) lumbrosacral
3) sacroiliac
4) pubic symphysis

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10
Q

What are the main ligaments of the hip bones you can see from the sagittal cut?

A

obturator membrane, sacrospinous ligament, sacrotuberous ligament

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11
Q

What are the main ligaments of the hip bones you can see from a posterior cut?

A

interosseous sacroiliac ligament (horizontal)
posterior sacroiliac ligament (vertical), Sacrotuberous ligament (diagonal)

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12
Q

What are the main ligaments of the hip bones you can see from an anterior cut?

A

Iliocolumbar ligament (horizontal), anterior sacroiliac ligaments (wide horizontal), sacrospinous ligament (low horizontal)

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13
Q

How is the greater sciatic foramen and lesser sciatic foramen separated?

A

sacrospinous ligament

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14
Q

What makes the second border of the lesser sciatic foramen?

A

sacrotuberous ligament

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15
Q

What exits out of the greater sciatic foramen?

A

superior gluteal nerve and artery, piriformis, interior gluteal nerve and artery, and the sciatic nerve

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16
Q

What exits out of the lesser sciatic foramen?

A

Internal pudendal artery and vein, pudendal nerve, obturator internus tendon, nerve to obturator

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17
Q

What is the lumbosacral plexus?

A

both lumbar and sacral plexus formed by anterior rami located on posterior wall, adjacent to spine, imbedded and into the psoas major muscle

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18
Q

What nerves make up the lumbosacral plexus?

A

(spinal nerves L4 to L5 and S1 to S4)

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19
Q

What are the two main nerves from the sacral plexus?

A

sciatic and pudendal

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20
Q

What is the sciatic nerve?

A

largest nerve of the body – L4-S3, converges, most commonly passing through greater sciatic foramina

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21
Q

What is the pudendal nerve?

A

main nerve of perineum and chief sensory nerve of external genitalia, S2-S4, skin, terminal parts of reproductive, urinary & digestive tracts

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22
Q

What is the pudendal plexus?

A

lying on posterior wall of pelvis, formed by branches of S2, S3, S4, S5, coccgeal nerve

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23
Q

What is the coccygeal plexus?

A

innervation of cocygeus, part of levator ani, sacrococcygeal joint, and supplies skin between tip of coccyx and anus

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24
Q

What do sympathetic fibers produce?

A

contraction of internal genital organs during orgasm and inhibit rectal peristalsis

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25
Q

What do parasympathetic fibers stimulate?

A

contraction of rectum/bladder for defecation and urination; erection

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26
Q

What are the 4 female pelvic arteries?

A

paired internal iliac artery, median sacral artery, superior rectal, paired ovarian artery

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27
Q

What are the 3 male pelvic arteries?

A

paired internal iliac artery, median sacral, superior rectal

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28
Q

What are the branches of the external iliac artery?

A

superficial gastric artery, inferior epigastric artery, superficial circumflex, superficial external pudendal artery, deep external pudendal

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29
Q

What are the branches of the internal iliac artery?

A

iliolumbar, lateral sacral, gluteal (superior/inferior), pudendal, inferior vesical (uterine), middle rectal, vaginal, obturator, umbilical

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30
Q

What is the pelvic floor?

A

support pelvic viscera and formed by pelvic diaphragm: levator ani, small coccygeus, covering fascia, incomplete anteriorly

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31
Q

What are the 3 parts of the levator ani muscle?

A

puborectalis -> pubococcygeus -> iliococcygeous

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32
Q

What muscle supports the vagina and prostate?

A

pubococcygeus muscle

33
Q

What is the coccygeus muscle?

A

coccyx -> ischial spine; posterior sheet that forms levator ani
tail that would wag
support and flexes the coccyx

34
Q

What causes pelvic floor dysfunction?

A

pudendal nerve (S2-S4) compression and stretching OR lumbosacral plexus injury (levator ani fails to reflexively contract with squeezing)

35
Q

What does the obturator internus do?

A

rotates thigh LATERALLY, helps abduct thigh

36
Q

How is the obturator internus supplied?

A

internal pudendal and superior/inferior gluteal artery. POSTERIOR cocyxx

37
Q

Does the obturator have a membrane?

A

yes - nerve, artery and vein pass through

38
Q

What is the piriformis?

A

anterior pelvis to 2-4th segments of sacrum; attached to tip of greater trochanter and lateral rotator with extension, abductor

39
Q

What is subperitoneal endopelvic fascia?

A

connective and fatty tissue that fills the space between organs and forms ligaments: cardinal, retrouterine (uterus!) and hypogastric sheath

40
Q

What is the perineum?

A

external surface and shallow compartment

41
Q

What is the urogenital diaphragm?

A

muscular membrane perforated by urethra and vagina, with fibrous mass between urethra/anal canal; final support of pelvic viscera in women

42
Q

Where is the superficial perineal pouch?

A

where the clitoris is

43
Q

Where is the deep perineal pouch?

A

deep and around area of urethra

44
Q

How do the ureters enter the bladder?

A

through muscular wall with a one way valve and the detrusor muscle tightens the bladder to prevent reflux

45
Q

How is the bladder innervated?

A

superior vesical artery (umbilical) and inferior vesical artery (internal iliac)

46
Q

How long is the female urethra?

A

3-4 cm long; supplied by internal pudendal and vaginal arteries

47
Q

What’s different about the male urethra?

A

transports semen and urine, four parts, and the intramural (prevents semen from entering bladder during ejaculation)

48
Q

What does the ductus deferens do?

A

carries sperm testis->ejaculatory duct
seminal vesical adds fluid and enters prostate and puts some milky fluid and opens the prostatic urethra

49
Q

What is the prostate?

A

size of a walnut, has its own sheath, participates in ejaculation

50
Q

What is the bulbo-urethral gland?

A

in external urethral sphincter (right before spongy urethra) that has mucus-like secretion during arousal to protect from acidic urine

51
Q

How long is the vagina?

A

7.5cm long, between bladder and rectum

52
Q

What is the Pouch of Douglas?

A

rectouterine pouch triangular made of fornices

53
Q

What does the fundus do in pregnancy?

A

expands

54
Q

What are the walls of the uterus?

A

serous - peritoneum and fat, muscular - myometrium, smooth muscle proliferation during pregnancy, mucosa - endometrium

55
Q

What is the broad ligament?

A

folds of peritoneum that attaches uterus to side walls of pelvis which consists of mesovarium (covers ovary), mesometrium (rest), mesosalpinx (uterine tube and hangs)

56
Q

What’s the ovarian ligament?

A

in broad ligament but attaches ovary to uterus

57
Q

What is the round ligament?

A

continuous with ovarian ligament and holds fundus of the uterus forward

58
Q

What are the suspensory ligaments?

A

peritoneal folds that cover supply

59
Q

What are uterosacral ligaments?

A

connects isthmus of uterus to sacrum

60
Q

What is “water under the bridge”?

A

uterine artery crosses over ureter

61
Q

How does the ureter run with internal iliac artery?

A

medial to and parallel

62
Q

What are fallopian tubes?

A

fimbriae -> infundibulum -> ampulla -> isthmus

63
Q

What is the communication between peritoneal cavity and outside environment?

A

ostium surrounds portion of ovary (aka fallopian tubes)

64
Q

What is key about the ovary drainage?

A

right ovarian -> IVC
left ovarian -> left renal vein

65
Q

Most common cause of cervical cancer?

A

HPV

66
Q

Where does cervical cancer metastasize first?

A

parametrial -> obturator -> pelvic -> para-aortic

67
Q

Where does uterine cancer metastasize first?

A

pelvic nodes or para-aortic

68
Q

Where does ovarian cancer metastasize first?

A

pelvic or para-aortic nodes

69
Q

What is the rectum?

A

continuous with sigmoid colon and anal canal; approx S3, end tip of coccyx

70
Q

What is the ichio-anal fossae?

A

space with fat and fascia that makes rectal abscesses very concerning

71
Q

What do you need to watch out for near the anal canal?

A

pudendal horizontal canal (Alcock’s canal) with vessels

72
Q

What is the pectinate line?

A

where the type of tissue changes, commonly at risk of cancer and different vasculature

73
Q

What are the parts of the body of the penis?

A

corpora cavernosa and corpus spongiosum; supplied by internal pudendal and dorsal nerves

74
Q

What may the penis have?

A

prepuce

75
Q

What causes an erection and subsequent ejaculation?

A

pudendal nerve, pelvic splanchnic nerves

76
Q

What nerve first leaves the pelvic via the greater sciatic foramen and then re-enters via the lesser sciatic foramen?

A

pudendal nerve

77
Q

What aids in ejaculation and assists in proper positioning of the fetus head?

A

levator ani muscle

78
Q

What is SADPUCKER?

A

S-subadrenal glands
A-aorta/IVC
D- duodenum
P-pancreas
U-ureters
C-colon
K-kidneys
E-esophagus
R-rectum

79
Q

Where is the rectosigmoid junction?

A

S3

Anatomy (22 decks)

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